A Social-Ecological View of Barriers and Facilitators for HIV Treatment Adherence: Interviews with Puerto Rican HIV Patients
Identifieur interne : 000F41 ( Pmc/Checkpoint ); précédent : 000F40; suivant : 000F42A Social-Ecological View of Barriers and Facilitators for HIV Treatment Adherence: Interviews with Puerto Rican HIV Patients
Auteurs : Eida M. Castro [États-Unis] ; Lydia E. Santiago [États-Unis] ; Julio C. Jiménez [États-Unis] ; Daira Dávila-Vargas [États-Unis] ; Milagros C. Rosal [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
To identify perceived barriers and facilitators for HAART adherence among people living with HIV/AIDS in Southern Puerto Rico using a Social Ecological framework.
Individual in-depths interviews were conducted with 12 HIV patients with a history of HAART non-adherence. Interviews were audio-taped and transcribed. Content analysis was performed for each transcribed interview by three independent coders using a codebook. Using Atlas TI, super-codes and families were generated to facilitate the categorization tree as well as grounded analyses and density estimates
Most participants reported a monthly income of $500 or less (n = 7), a high school education level (n = 7), being unemployed (n = 9) and being recipients of government health insurance (n = 11). Three out of six women reported living alone with their children and most men informed living with their parents or other relatives (n = 4). For the grounded analyses, the top four sub-categories linked to high number of quotations were mental health barriers (G = 32) followed by treatment regimen (G = 28), health system (G = 24) and interpersonal relations (G = 16). The top four sub-categories linked to high number of codes are treatment regimen (D = 4), health status perception (D = 3), interpersonal relations (D = 3) and health system (D = 3).
The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels. Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior
Url:
DOI: 10.1371/journal.pone.0125582
PubMed: 26422049
PubMed Central: 4589346
Affiliations:
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<author><name sortKey="Santiago, Lydia E" sort="Santiago, Lydia E" uniqKey="Santiago L" first="Lydia E." last="Santiago">Lydia E. Santiago</name>
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<author><name sortKey="Rosal, Milagros C" sort="Rosal, Milagros C" uniqKey="Rosal M" first="Milagros C." last="Rosal">Milagros C. Rosal</name>
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Purpose</title>
<p>To identify perceived barriers and facilitators for HAART adherence among people living with HIV/AIDS in Southern Puerto Rico using a Social Ecological framework.</p>
</sec>
<sec id="sec002"><title>Patients and Methods</title>
<p>Individual in-depths interviews were conducted with 12 HIV patients with a history of HAART non-adherence. Interviews were audio-taped and transcribed. Content analysis was performed for each transcribed interview by three independent coders using a codebook. Using Atlas TI, super-codes and families were generated to facilitate the categorization tree as well as grounded analyses and density estimates</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>Most participants reported a monthly income of $500 or less (n = 7), a high school education level (n = 7), being unemployed (n = 9) and being recipients of government health insurance (n = 11). Three out of six women reported living alone with their children and most men informed living with their parents or other relatives (n = 4). For the grounded analyses, the top four sub-categories linked to high number of quotations were mental health barriers (G = 32) followed by treatment regimen (G = 28), health system (G = 24) and interpersonal relations (G = 16). The top four sub-categories linked to high number of codes are treatment regimen (D = 4), health status perception (D = 3), interpersonal relations (D = 3) and health system (D = 3).</p>
</sec>
<sec id="sec004"><title>Conclusion</title>
<p>The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels. Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26422049</article-id>
<article-id pub-id-type="pmc">4589346</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0125582</article-id>
<article-id pub-id-type="publisher-id">PONE-D-14-39051</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>A Social-Ecological View of Barriers and Facilitators for HIV Treatment Adherence: Interviews with Puerto Rican HIV Patients</article-title>
<alt-title alt-title-type="running-head">Barriers and Facilitators for HIV Treatment Adherence in Puerto Ricans</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Castro</surname>
<given-names>Eida M.</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
<xref rid="cor001" ref-type="corresp">*</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Santiago</surname>
<given-names>Lydia E.</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Jiménez</surname>
<given-names>Julio C.</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Dávila-Vargas</surname>
<given-names>Daira</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Rosal</surname>
<given-names>Milagros C.</given-names>
</name>
<xref ref-type="aff" rid="aff004"><sup>4</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>Clinical Psychology Programs, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico, United States of America</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>Psychiatry Department, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico, United States of America</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>University of Puerto Rico Medical Science Campus School of Nursing, San Juan, Puerto Rico, United States of America</addr-line>
</aff>
<aff id="aff004"><label>4</label>
<addr-line>University of Massachusetts Medical School, Worcester, Division of Preventive and Behavioral Medicine, Massachusetts, United States of America</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Kumar</surname>
<given-names>Anil</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>University of Missouri-Kansas City, UNITED STATES</addr-line>
</aff>
<author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: EC LS JJ MCR. Performed the experiments: EC DD-V. Analyzed the data: EC. Contributed reagents/materials/analysis tools: EC. Wrote the paper: EC LS JJ DD-V MCR.</p>
</fn>
<corresp id="cor001">* E-mail: <email>ecastro@psm.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>30</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>10</volume>
<issue>9</issue>
<elocation-id>e0125582</elocation-id>
<history><date date-type="received"><day>17</day>
<month>9</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>25</day>
<month>3</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-year>2015</copyright-year>
<copyright-holder>Castro et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0125582.pdf"></self-uri>
<abstract><sec id="sec001"><title>Purpose</title>
<p>To identify perceived barriers and facilitators for HAART adherence among people living with HIV/AIDS in Southern Puerto Rico using a Social Ecological framework.</p>
</sec>
<sec id="sec002"><title>Patients and Methods</title>
<p>Individual in-depths interviews were conducted with 12 HIV patients with a history of HAART non-adherence. Interviews were audio-taped and transcribed. Content analysis was performed for each transcribed interview by three independent coders using a codebook. Using Atlas TI, super-codes and families were generated to facilitate the categorization tree as well as grounded analyses and density estimates</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>Most participants reported a monthly income of $500 or less (n = 7), a high school education level (n = 7), being unemployed (n = 9) and being recipients of government health insurance (n = 11). Three out of six women reported living alone with their children and most men informed living with their parents or other relatives (n = 4). For the grounded analyses, the top four sub-categories linked to high number of quotations were mental health barriers (G = 32) followed by treatment regimen (G = 28), health system (G = 24) and interpersonal relations (G = 16). The top four sub-categories linked to high number of codes are treatment regimen (D = 4), health status perception (D = 3), interpersonal relations (D = 3) and health system (D = 3).</p>
</sec>
<sec id="sec004"><title>Conclusion</title>
<p>The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels. Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior</p>
</sec>
</abstract>
<funding-group><funding-statement>The project was supported by Grant Number S21MD001830 and Award Number U54 RR026139 from the National Center for Research Resources(<ext-link ext-link-type="uri" xlink:href="http://www.ncrr.nih.gov/">http://www.ncrr.nih.gov/</ext-link>
) and the Award Number 8U54MD 007587-03 and 2-G12-MD007579-29 from the National Institute of Minority Health and Health Disparities (<ext-link ext-link-type="uri" xlink:href="http://www.nimhd.nih.gov/">http://www.nimhd.nih.gov/</ext-link>
. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts><fig-count count="2"></fig-count>
<table-count count="3"></table-count>
<page-count count="18"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>All relevant data are within the paper and its Supporting Information files. Data can also be obtained by contacting the authors at Ponce Health Sciences University and emailing the Principal Investigator, Eida M. Castro, at <email>ecastro@psm.edu</email>
.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>All relevant data are within the paper and its Supporting Information files. Data can also be obtained by contacting the authors at Ponce Health Sciences University and emailing the Principal Investigator, Eida M. Castro, at <email>ecastro@psm.edu</email>
.</p>
</notes>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Massachusetts</li>
</region>
</list>
<tree><country name="États-Unis"><noRegion><name sortKey="Castro, Eida M" sort="Castro, Eida M" uniqKey="Castro E" first="Eida M." last="Castro">Eida M. Castro</name>
</noRegion>
<name sortKey="Castro, Eida M" sort="Castro, Eida M" uniqKey="Castro E" first="Eida M." last="Castro">Eida M. Castro</name>
<name sortKey="Davila Vargas, Daira" sort="Davila Vargas, Daira" uniqKey="Davila Vargas D" first="Daira" last="Dávila-Vargas">Daira Dávila-Vargas</name>
<name sortKey="Jimenez, Julio C" sort="Jimenez, Julio C" uniqKey="Jimenez J" first="Julio C." last="Jiménez">Julio C. Jiménez</name>
<name sortKey="Rosal, Milagros C" sort="Rosal, Milagros C" uniqKey="Rosal M" first="Milagros C." last="Rosal">Milagros C. Rosal</name>
<name sortKey="Santiago, Lydia E" sort="Santiago, Lydia E" uniqKey="Santiago L" first="Lydia E." last="Santiago">Lydia E. Santiago</name>
</country>
</tree>
</affiliations>
</record>
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